Will it come back to haunt me

[RNMoxie]

I had a patient recently decided to light up a cigarette on a medsurg floor. Not sure where he got the cigarettes and lighter, he was on our floor for weeks and never did this prior. I only had him in my assignment for a day and a half. He's AAOx4 with multiple behavioral corrections and a schizophrenic diagnosis. Full grip strength and strong upper extremity ROM. A tech and LPN were trying to convince him to put down the lit cigarette he was puffing on. He kept moving the cigarette threatening to burn them or holding it out of reach. I heard the commotion next door when I was with my patient on oxygen. I processed for about 10 seconds the best resolution with my main focus being to put out the fire hazard, avoid injury to the patient and staff, and ending the cigarette smoke throughout the hall. I filled a water pitcher with water and threw it on the cigarette getting the patient partially wet, but extinguishing the hazard. In other words, I threw a bucket of water on a patient. The same question keeps running through my mind. What could I have done to handle this better? Will this come back to haunt me? My nurse manager does not seem to be upset with me. I haven't been called to be reprimanded... yet. Can I please get some outside perspective?

[hppygr8ful, ASN, RN, EMT-I]

FolksBtrippin said:

The BON is actually not required to investigate any and all complaints. 

I probably should have used different language and stated something about state specifics. I know in CA the BON investigates all complaints. Sometimes that's just a phone interview to get the nurses side of the story.

[RNMoxie]

FolksBtrippin said:

I'm not currently in a leadership role but I have been a nurse manager. What do YOU think you should have done differently? What would you do as a nurse manager if a nurse under you behaved the same way? 
 

Be aware that in order to bar someone from promotion as a disciplinary measure, there needs to be a write up. You will not be a good manager if your first thought is to punish a nurse in this situation. So adjust yourself accordingly. 

I love this response. When I first went into bedside nursing, it was HCA. It provided many traumatic experiences to the point where I thought I'm just a terrible person and an even worse nurse. I try to do everything in my power now to uplift other nurses and healthcare staff. I never want to be the nurse manager that doesn't support. I'm saving this as a screenshot because I love how grounding it is.

 

[JzK CCRN, BSN, EMT-I]

As I was reading the OP, I thought of fire extinguisher 🧯. But water works well. Maybe flushes in the future?

One of the hospitals that I work in, they'd call security on patient, make a huge stick, blame RNs LOL another hospital that I work in - they'd ask why I didn't use a bigger bucket of water. 

As for your leadership... You came up with an unusual solution to an unusual problem. 

[RNMoxie]

JzK CCRN said:

As I was reading the OP, I thought of fire extinguisher 🧯. But water works well. Maybe flushes in the future?

One of the hospitals that I work in, they'd call security on patient, make a huge stick, blame RNs LOL another hospital that I work in - they'd ask why I didn't use a bigger bucket of water. 

As for your leadership... You came up with an unusual solution to an unusual problem. 

I did think of the fire extinguisher, but I didn't want to break the glass or make the patient and staff inhale that.
The flush is out of the question. My aim sucks. I cannot hit a cigarette from 5 feet away with 10 mL of liquid. I don't know if I could do it with a cup of 200 mL, especially with the patient moving the cigarette around. I purposely chose the water pitcher liner because I couldn't miss with that.

[JzK CCRN, BSN, EMT-I]

RNMoxie said:

I did think of the fire extinguisher, but I didn't want to break the glass or make the patient and staff inhale that.
The flush is out of the question. My aim sucks. I cannot hit a cigarette from 5 feet away with 10 mL of liquid. I don't know if I could do it with a cup of 200 mL, especially with the patient moving the cigarette around. I purposely chose the water pitcher liner because I couldn't miss with that.

Y'all don't play water guns at work? 😆

Oh the stories ... That never existed 😂 

[Patricia Ordnung]

You're the bomb!  I never would have thought of that! 

[Maltmom0402RN]

You are my hero!  Had a patient who smoked on o2 and was burned pretty bad.  You may have saved him and others from ptsd from dealing with it.  Bravo!

[QueenB.RN]

Yes. Since it wasn't your patient, the very best thing would've been to call Security. Let them deal with any patient trying to cause harm. Throwing water on them could've escalated the situation to a dangerous level. 
I'm a NM.

[CalicoKitty, BSN, MSN, RN]

At first I wondered if you were getting a fire extinguisher.. I kind of mentioned to people that if there's a dangerou situation and they want to stay somewhat hands off, fire extinguishers can probably be useful.. But in your situation, water sounds like a reasonable choice. "If you are smoking, I assume you are on fire"...

[Hannahbanana, BSN, MSN]

Davey Do said:

Had I thrown water on a patient smoking a cigarette, I'd probably say something like, "There was an imminent danger to the patient, staff, and surroundings and I appropriately reacted".

Oh, yeah: I was an NS in two different facilities.

This situation reminds me of a similar accident some years ago of a nongeriatric patient on the geriatric psych floor because he suffered facial burns due to lighting up a joint at home while on oxygen. That patient was a major behavioral pain. He was a bear.

I posted a cartoon I did at the time on allnurses of Smokey the Bear receiving oxygen through a nasal cannula with a caption reading, "Only you can prevent facial fires".

Heh!

Hi Davey Do, long time no see!